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Radiological and micro‐computed tomography analysis of the bone at dental implants inserted 2, 3 and 4 mm apart in a minipig model with platform switching incorporated
Author(s) -
Elian Nicolas,
Bloom Mitchell,
Dard Michel,
Cho SangChoon,
Trushkowsky Richard D.,
Tarnow Dennis
Publication year - 2014
Publication title -
clinical oral implants research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.407
H-Index - 161
eISSN - 1600-0501
pISSN - 0905-7161
DOI - 10.1111/clr.12037
Subject(s) - radiography , mandible (arthropod mouthpart) , implant , dentistry , medicine , dental implant , osseointegration , radiological weapon , tomography , orthodontics , radiology , surgery , botany , biology , genus
Background The purpose of this study was to assess the effect of inter‐implant distance on interproximal bone utilizing platform switching. Analysis of interproximal bone usually depends on traditional two‐dimensional radiographic assessment. Although there has been increased reliability of current techniques, there has been an inability to track bone level changes over time and in three dimensions. Micro‐ CT has provided three‐dimensional imaging that can be used in conjunction with traditional two‐dimensional radiographic techniques. Methods This study was performed on 24 female minipigs. Twelve animals received three implants with an inter‐implant distance of 3 mm on one side of the mandible and another three implants on the contra‐lateral side, where the implants were placed 2 mm apart creating a split mouth design. Twelve other animals received three implants with an inter‐implant distance of 3 mm on one side of the mandible and another three implants on the contra‐lateral side, where the implants were placed 4 mm apart creating a split mouth design too. The quantitative evaluation was performed comparatively on radiographs taken at t 0 (immediately after implantation) and at t 8 weeks (after termination). The samples were scanned by micro‐computed tomography (μCT) to quantify the first bone to implant contact ( fBIC ) and bone volume/total volume (BV/TV). Mixed model regressions using the nonparametric Brunner–Langer method were used to determine the effect of inter‐implant distance on the measured outcomes. Results The change in bone level was determined using radiography and its mean was 0.05 mm for an inter‐implant distance of 3 and 0.00 mm for a 2 mm distance ( P = 0.7268). The mean of this outcome was 0.18 mm for the 3 mm and for 4 mm inter‐implant distance ( P = 0.9500). Micro‐computed tomography showed that the fBIC was always located above the reference, 0.27 and 0.20 mm for the comparison of 2–3 mm ( P = 0.4622) and 0.49 and 0.34 mm for the inter‐implant distance of 3 and 4 mm ( P = 0.1699). BV/TV inside the defined parallelepipedic masks reached 82.38% for the 2 mm inter‐implant distance and 85.00% for 3 mm, P = 0.8432. For the comparison of the 3–4 mm inter‐implant distance, the means were 84.69% and 84.38%, respectively, P = 0.8401. Non‐inferiority tests for the smaller inter‐implant distances for both comparisons showed similar differences and similar tolerance ranges. Conclusion The effect of a smaller interproximal distances between implants on bone level, fBIC and BV/TV assessed by two convergent investigation methods, radiology and μCT, was similar to that of larger distances. Implants can potentially be placed 2 mm apart instead of 3 mm and 3 mm apart instead of 4 mm when platform switching is utilized. Further research with a conventional platform is warranted.